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Comparison between empirical prokinetics, Helicobacter test-and-treat and empirical endoscopy in primary-care patients presenting with dyspepsia: A one-year study

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World Journal of Gastroenterology 2006年第31期12卷 5010-5016页

作者： Wayne HC Hu SK Lam Cindy LK Lam WM wong KF Lam KC Lai yh wong Benjamin CY wong Annie OO Chan CK Chan Gabriel M Leung WM Hui Department of Medicine University of Hong Kong Hong Kong China Department of Statistics and Actuarial Science University of Hong Kong Hong Kong China Department of Community Medicine University of Hong Kong Hong Kong China

AIM： To investigate the optimal strategy to treat dyspeptic patients in primary care. METHODS： Dyspeptic patients presenting to primary care outpatient clinics were randomly assigned to- （1） empirical endoscopy, （2） H pylori test-and-treat, and （3） empirical prokinetic treatment with cisapride. Early endoscopy was arranged if patients remained symptomatic after 2 wk. Symptom severity, quality-of-life （SF-36） as well as patient preference and satisfaction were assessed. All patients underwent endoscopy by wk 6. Patients were followed up for one year. RESULTS： Two hundred and thirty four patients were recruited （163 female, mean age 49）. 46% were H pylori positive. 26% of H pylori tested and 25% of empirical prokinetic patients showed no improvement at wk 2 follow-up and needed early endoscopy. 15% of patients receiving empirical cisapride responded well to treatment but peptic ulcer was the final diagnosis. Symptom resolution and quality-of-life were similar among the groups. Costs for the three strategies were HK$4343, $1771 and $1750 per patient. 66% of the patients preferred to have early endoscopy. CONCLUSION： The three strategies are equally effective. Empirical prokinetic treatment was the least expensive but peptic ulcers may be missed with this treatment. The H pylori test-and-treat was the most cost-effective option .

关键词： Empirical endoscopy Dyspeptic patients Hpylori test-and treat

Differing coping mechanisms, stress level and anorectal physiology in patients with functional constipation

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World Journal of Gastroenterology 2005年第34期11卷 5362-5366页

作者： Annie OO Chan Cecilia Cheng Wai Mo Hui Wayne HC Hu Nina yh wong KF Lam Wai Man wong Kam Chuen Lai Shiu Kum Lam Benjamin CY wong Department of Medicine the University of Hong Kong Hong Kong China Division of Social Science the Hong Kong University of Science and Technology Hong Kong China Department of Medicine the University of Hong Kong Hong Kong China Department of Statistics the University of Hong Kong Hong Kong China

AIM: To investigate coping mechanisms, constipation symptoms and anorectal physiology in 80 constipated subjects and 18 ***: Constipation was diagnosed by Rome Ⅱ *** ability and anxiety/depression were assessed by validated questionnaires. Transit time and balloon distension test were ***: 34.5% patients were classified as slow transit type of constipation. The total colonic transit time (56 h vs 10 h, P＜0.0001) and rectal sensation including urge sensation (79 mL vs 63 mL, P = 0.019) and maximum tolerable volume (110 mL vs95 mL, P = 0.03) differed in patients and controls. Constipated subjects had significantly higher anxiety and depression scores and lower SF-36 scores in all categories. They also demonstrated higher scores of'monitoring' coping strategy (14+6 vs9+3, P = 0.001),which correlated with the rectal distension sensation (P = 0.005), urge sensation (P=0.002), and maximum tolerable volume (P = 0.035). The less use of blunting strategy predicted slow transit constipation in both univariate (P = 0.01) and multivariate analysis (P = 0.03).CONCLUSION: Defective or ineffective use of coping strategies may be an important etiology in functional constipation and subsequently reflected in abnormal anorectal physiology.

关键词： Constipation Anorectal physiology Coping mechanism

The control of glial cell activity by dorsal root ganglion neurons

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The control of glial cell activity by dorsal root ganglion n...

Effects of primary glaucoma on sleep quality and daytime sleepiness of patients residing at an equatorial latitude

中国药理学会第十一次全国学术会议

作者： H WISH KBS CHOW B YEUNG KY NG CHT CHU KH TSE WK LEUNG yh wong School of Biomedical Sciences The Chinese University of Hong Kong Faculty of Dentistry The University of Hong Kong Division of Life Science The Hong Kong University of Science and Technology

OBJECTIVE Pain sensations in the periphery are carried by primary sensory neurons whose cell bodies lay in the dorsal root ganglia(DRG).The present study focuses on examining the interactions between DRG neurons and glial cells in vitro in relation to their roles as detectors of tissue *** Acutely dissociated DRG cells were isolated from adult SD rats,and plated on poly-DL-ornithine and laminin-coated tissue culture *** in 3 cell groups were compared over time in culture: mixed DRG cells(45%neurons on plating),neuron-enriched cells(70%neurons on plating) and glial cells(99%glial cells on plating).Cell proliferation was determined by counting cells,protein assay and MTT assay.[H]cAMP production in the presence of specific receptor agonists and antagonists was assayed to detect Gs-coupled *** acidic fibrillary protein(GFAP),glutamine synthase(GS) and Toll-like receptor 4(TLR4) mRNA and protein expression were determined by real time PCR and immunocyto-chemistry, *** The presence of Gs-coupledβAR,CGRP,EP and IP receptors were identified in glial cell preparations although only CGRP receptors have been reported on satellite glial cells in ***,IP receptor-stimulated adenylyl cyclase activity in glial cells was significantly inhibited by the presence of DRG *** neurons did not overtly affect glial cell proliferation or the expression of GFAP(classical markers of glial cell activation),but appeared to inhibit the expression of TLR4 and prevent the loss of GS in glial *** Time-dependent changes occur in DRG glial cells in vitro with regard to the expression of TLR4,Gs-coupled receptors and glial cell markers,and all these changes are influenced by the presence of DRG neurons. Whether similar neuron-glial interactions occur in vivo remains to be determined.

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International Journal of Ophthalmology(English edition) 2020年第9期13卷 1451-1458页

作者： Jacob yh Chin Zhi Hong Toh Ying Tai Lo Hannah TY Wang Elizabeth YW Poh Chun Hau Chua Owen Kim Hee Boon Ang Lim Vernon KY Yong Augustinus Laude Hon Tym wong Leonard WL Yip Department of Ophthalmology National Healthcare Group Eye InstituteTan Tock Seng Hospital308433Singapore Monash School of Medicine Monash UniversityVictoria 3800Australia

AIM:To investigate the impact of primary glaucoma on sleep quality and daytime sleepiness of ***:Prospective cross-sectional study with consecutive sampling in South-East Asian population was *** questionnaires:the Pittsburg Sleep Quality Index(PSQI)and Epworth Sleepiness Scale(ESS)were administered *** with nonglaucomatous optic neuropathy or concomitant retinal pathology were *** severity was based on HVF 24-2 *** single vision was represented based on the better *** of and predictive factors for poor sleep quality and excessive daytime sleepiness were ***:A total of 79 primary open angle glaucoma(POAG),27 primary angle-closure glaucoma(PACG)patients,and 89 controls were *** patients had higher median PSQI scores(P=0.004)and poorer sleep quality(P<0.001).Compared to controls,PACG patients were 3.34 times more likely to have poor sleep quality(P=0.008),which remained significant after adjustment for demographics(P=0.016)and predictive variables(P=0.013).PACG patients have poorer sleep quality when visual acuity(VA)was 6/15 or worse(P=0.009).Univariate and multivariate analysis of predictive variables for poor sleep quality and daytime sleepiness did not find statistical ***:PACG patients have poorer sleep quality but not daytime *** is important in South-East Asian population with heavy disease *** on sleep disturbances can be considered to provide more ho istic care.

关键词： sleep disturbances primary glaucoma intrinsically photosensitive retinal ganglion cells daytime sleepiness sleep quality South-East Asia

β_2-adrenoceptor in obstructive airway diseases:Agonism, antagonism or both?

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World Journal of Respirology 2015年第3期5卷 199-206页

作者： Daniel WS Tan Jyi Lin wong Siew Teck Tie John A Abisheganaden Albert yh Lim WS Fred wong Department of Pharmacology Yong Loo Lin School of MedicineNational University Health System Respiratory Unit Department of MedicineSarawak General Hospital Department of Respiratory and Critical Care Medicine Tan Tock Seng Hospital Immunology Program Life Science InstituteNational University of Singapore

Obstructive airway disease is a complex disease entity including several maladies characterized by bronchoconstriction and abnormal airway inflammation. Reversing bronchoconstriction leads to symptomatic relief and improvement in quality of life, both in reversible(bronchial asthma) and partially reversible(chronic obstructive airway disease) obstructive airway diseases. β2-adrenoceptor expressed in human airway is the main β-receptor subtype, and its activation in airway smooth muscle cells leads to bronchodilatation. Drugs targeting β-adrenoceptors have been around for many years, for which agonists of the receptors are used in bronchodilation while antagonists are used in cardiovascular diseases. This review article summarizes the effect and usage of β2-agonist in obstructive airway disease, addressing the benefits and potential risks of β2-agonist. The article also looks at the safety of β-blocker usage for cardiovascular disease in patients with obstructive airway disease. There is also emerging evidence that non-selective β-blockers with inverse agonism ironically can have longterm beneficial effects in obstructive airway disease that is beyond cardiovascular protection. Further trials are urgently needed in this area as it might lead to a dramatic turnaround in clinical practice for obstructive airway diseases as has already been seen in the usage of β-blockers for heart failure.

关键词： β-adrenoceptors β2-agonist β-blocker Inverse agonist Heart failure β-arrestin